Combination antifungal therapy against resistant C. albicans: efficacy and immune response in mice.

This study demonstrates the therapeutic effects of combination therapies against Candida albicans in mouse models, as opposed to mono-therapeutic treatments, while also comparing the pathogenicity of both sensitive and resistant strains. Fluconazole-resistant strain of Candida albicans was isolated from an infected patient, and its infectivity potential was compared with a susceptible strain by injecting a fungal cell suspension into the mice model. Additionally, the level of secretory interleukin 17 in the mice was examined. Furthermore, the efficacy of combination therapy was assessed using Fluconazole-Caspofungin (Flu-Cas) and Fluconazole-Amphotericin B (Flu-AmB) in comparison to monotherapy. The results indicate that the resistant strain exhibits higher pathogenicity compared to the susceptible strain in inducing systemic infection within the mouse model, as significant differences between the resistant and susceptible groups were observed at day 5 (p = 0.0401) and day 7 (p = 0.0182). The concentrations of IL-17 (pg/ml) on days 1 to 7 were 43.66 to 259 pg/ml, and 39.66 to 210 pg/ml in resistant and susceptible groups, respectively, which were only significant on days 5 (p = 0.0356) and 7 (p = 0.0280). Combination therapies using Flu-Cas and Flu-AmB demonstrated an effective reduction in fungal colonization after 17 days. This study demonstrates that Fluconazole-resistant Candida albicans strains are more pathogenic than susceptible ones in mice. Combination therapies with Fluconazole-Amphotericin B were most effective in reducing fungal colonization, outperforming monotherapy. These results support combination treatment for resistant Candida infections.